A 36-year-old pregnant client presents for prenatal care. Her last menstrual period began on May 3, 2024. She asks about her EDD and when she should expect Rh immune globulin since she is Rh-negative. Using Naegele's Rule, the nurse calculates her EDD and provides teaching, Which response by the nurse is most accurate?
Explanation & Rationale
Rationale: A. "Your EDD is January 26, 2025, and RhIG is not needed since you're 36." – The EDD is miscalculated, and maternal age does not determine the need for Rh immune globulin (RhIG). RhIG administration is based on Rh incompatibility between the mother and fetus, not age. B. "Your EDD is February 10, 2025, and RhIG is given at 28 weeks and postpartum if the infant is Rh-positive." – Using Naegele’s Rule (add 7 days to the first day of the last menstrual period and count forward 9 months): LMP: May 3, 2024 +7 days → May 10, 2024 +9 months → February 10, 2025 Thus, the EDD is February 10, 2025. Because the client is Rh-negative, RhIG is administered at 28 weeks’ gestation and within 72 hours postpartum if the newborn is Rh-positive, or after any potential exposure to fetal blood (e.g., amniocentesis, trauma, miscarriage). C. "Your EDD is February 17, 2025, and RhIG is only needed if you deliver preterm." – RhIG is not dependent on preterm delivery; it is routinely given at 28 weeks and postpartum if the baby is Rh-positive. The EDD is also miscalculated. D. "Your EDD is February 3, 2025, and RhIG is given at your first prenatal visit." – RhIG is not administered at the first prenatal visit; it is given at 28 weeks’ gestation and postpartum if indicated. The EDD is also slightly miscalculated.